Doctors told Rep. Cindy Evans, D-7th (N. Kona, S. Kohala), and others at an open panel that tort reform is needed to allow doctors to practice without the fear of lawsuits.

"Doctors are not saying tort reform will solve all the problems," said orthopedic surgeon Barry Blum, the Kona Community Hospital medical director. "We're asking that you allow doctors to practice without a big fat target on them."

Patients must have the right to recoup their losses and attorney fees, but Blum said doctors will continue leaving rural areas of the state and hospitals will struggle to recruit new ones without some protection against future lawsuits.

Kona orthopedic surgeon John Bellatti said tort reform will make a difference, but disagreed that medical professionals need to take the first steps, which was suggested by Evans.

"You are saying why don't the doctors get together for coffee and talk about it. Duh. We have talked about it," he said. "No, we want you to discuss it in public."

Evans said she voted against the tort reform bill in the Judiciary Committee because it was too simplistic and needed strengthening.

House Judiciary Committee chairman Rep. Tommy Waters, a trial lawyer, was also reluctant to spend time on it this session, Evans said.

She said a test case scenario needs to be added for instances of negligence or catastrophic injury.

"We have to define that test," she said. "I'm not about not trying to solve these things."

Rep. Angus McKelvey, D-10th (Lahaina, Ka'anapali, Kapalua), who also sits on the Judiciary Committee, said he would have preferred the bill, even though flawed, be discussed at committee level. He said the legislation needs improvements.

"We want a bill that will actually do some good," he said. "We have to. People are dying."

Doug Hiller, an orthopedic surgeon with offices in Waimea and Hilo, said the lack of access to medical care is making the neighbor islands unsafe for residents and visitors.

"It's the responsibility of the state to create a safe environment," he said.

Currently there are no quick, reliable ways to get patients to O'ahu's medical centers, he said.

Those doctors on-call must be within 20 minutes of the hospital or face a $50,000 fine while often leaving their families and must carry the liability.

"And you do all that for free," Hiller said. "What kind of a moron would sign up for a deal like that?"